Totally retroperitoneal approach for robot-assisted nephroureterectomy with bladder cuff without repositioning.

Autor: Hattori Y; Department of Urology, Kobe City Medical Center General Hospital, Kobe, Japan., Yamamoto A; Department of Urology, Kobe City Medical Center General Hospital, Kobe, Japan., Nagoshi A; Department of Urology, Kobe City Medical Center General Hospital, Kobe, Japan., Fujiwara T; Department of Urology, Kobe City Medical Center General Hospital, Kobe, Japan., Kambe T; Department of Urology, Kobe City Medical Center General Hospital, Kobe, Japan., Igarashi A; Department of Urology, Kobe City Medical Center General Hospital, Kobe, Japan., Akagi N; Department of Urology, Kobe City Medical Center General Hospital, Kobe, Japan., Shibasaki N; Department of Urology, Kobe City Medical Center General Hospital, Kobe, Japan., Kawakita M; Department of Urology, Kobe City Medical Center General Hospital, Kobe, Japan., Yamasaki T; Department of Urology, Kobe City Medical Center General Hospital, Kobe, Japan.
Jazyk: angličtina
Zdroj: Asian journal of endoscopic surgery [Asian J Endosc Surg] 2024 Jul; Vol. 17 (3), pp. e13317.
DOI: 10.1111/ases.13317
Abstrakt: Introduction: Robot-assisted nephroureterectomy (RANU) for upper urinary tract urothelial carcinoma is typically performed via the transperitoneal approach because of limited surgical space. However, a retroperitoneal approach may be preferable in patients with a history of abdominal surgery or in those in whom pelvic lymph node dissection is unnecessary.
Materials and Surgical Techniques: RANU via the retroperitoneal approach was selected for two patients diagnosed with high-grade upper urothelial carcinoma with a history of abdominal surgery. Nephrectomy was performed in the 90° flank position, and the bed was tilted at 20°. The retroperitoneal space was extended, and the robot trocar was subsequently repositioned in the left lower quadrant. After redocking the robot, the distal ureter was dissected, and the bladder cuff was resected en bloc along with the kidney and the ureter. Neither patient had any complications within 3 months postoperatively.
Discussion: By devising a new technique for trocar placement, total retroperitoneal RANU without repositioning was possible, even in a small patient.
(© 2024 Asia Endosurgery Task Force and Japan Society of Endoscopic Surgery and John Wiley & Sons Australia, Ltd.)
Databáze: MEDLINE
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